Stein Hubert, Kang Sang Wook, Heo Seung Young, Rheinwald Markus
Department of Surgical Applications Engineering, Intuitive Surgical Inc., Sunnyvale, CA, United States.
Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Front Surg. 2023 Jun 15;10:1196021. doi: 10.3389/fsurg.2023.1196021. eCollection 2023.
This study aims to study the feasibility of a remote-access thyroidectomy through presternal and submental approaches with the da Vinci SP system.
Bilateral thyroidectomies were performed in five cadaveric models. A single incision in the presternal area was used in two cadavers, and a submental facelift incision approach was used in three cadavers.
Performing remote-access thyroidectomy was completed with a presternal approach in one cadaver and with the submental approach in three cadavers. The required skin flap development was minimal, and the docking time for the SP system was quick for all procedures. Time to full exposure of the thyroid gland after skin incision was less than 30 min for the presternal approach and less than 27 min for the submental procedure. Completing total thyroidectomies took 83 min in the presternal approach and between 67 and 127 min in the submental access. No additional ports were required to expose the gland and complete the bilateral resection.
Total thyroidectomy was feasible with the da Vinci SP system in single incision presternal and submental approaches comparing promisingly with other currently applied robotic methods. Further studies will be required to assess whether a presternal or submental thyroidectomy with the da Vinci SP system provides clinical benefits in real patients.
本研究旨在探讨使用达芬奇SP系统通过胸骨前和颏下途径进行远程甲状腺切除术的可行性。
在五个尸体模型上进行双侧甲状腺切除术。两具尸体采用胸骨前区域单一切口，三具尸体采用颏下除皱切口入路。
在一具尸体上通过胸骨前入路完成了远程甲状腺切除术，在三具尸体上通过颏下入路完成。所需皮瓣分离最少，所有手术中SP系统的对接时间都很快。胸骨前入路皮肤切开后甲状腺完全暴露时间少于30分钟，颏下入路少于27分钟。胸骨前入路完成全甲状腺切除术耗时83分钟，颏下入路耗时67至127分钟。暴露腺体并完成双侧切除无需额外切口。
使用达芬奇SP系统通过单一胸骨前和颏下切口入路进行全甲状腺切除术是可行的，与目前应用的其他机器人手术方法相比前景良好。需要进一步研究来评估使用达芬奇SP系统进行胸骨前或颏下甲状腺切除术是否能给实际患者带来临床益处。
